Does the contribution of human milk oligosaccharides to the beneficial effects of breast milk allow us to hope for an improvement in infant formulas?

Human milk is a source of nutrients and contains many distinct bioactive components. Among these, human milk oligosaccharides (HMOs) have attracted considerable attention and are being investigated as a "novel foods". Human milk is unique in its oligosaccharide composition. Recent research has focused on the complexity of HMOs by highlighting their diversity, structural variability, concentration variance, and structure-function relationships. In vitro and in vivo studies have demonstrated that HMOs drive infant gut microbiota, improve intestinal barrier functions, and modulate cell receptor signaling, thereby contributing to the development of infant immunity. These studies, combined with epidemiological data, indicate that some HMO may confer health benefits by preventing infections and diseases such as necrotizing enterocolitis and allergies. However, randomized controlled trials are restricted to structurally simple compounds such as 2' fucosyllactose and lacto-N-neotetraose. More controlled clinical trials are needed to justify routine supplementation of formula. It is felt that a better understanding of the role of HMOs leading to the development of inexpensive methods for large-scale HMO production is needed.